By Thomas H. Dahlborg, MSHSM

President, Dahlborg Healthcare Leadership Group (DHLG)

Director, Health Care Global Listening Centre Board

As many of us seek to be effective leaders at home, at work (but perhaps working from home) and in our communities as COVID-19 continues to impact our lives, it’s an especially timely occasion to talk about the critical importance of being agile.

Leadership agility is often defined as having the ability to:

  • Make smart and effective decisions in a rapidly changing world;
  • Being able to anticipate the best way to go forward;
  • Knowing how to inspire – and then doing so;
  • Measuring and leveraging data.

But let’s hold that thought for a moment …

Many quote W. Edwards Deming, the quality improvement guru, as saying: “You can’t manage what you can’t (or don’t) measure.”

Makes sense, right?

Actually, no. And as a matter of fact, Deming never actually said that. Indeed, he said just the opposite. What he actually said was, “the most important things that one needs for management are unknown or unknowable.”

And yet we have to manage them anyway.

So we need to learn to live in the grey, the unknowable space, and still make wise and reasoned decisions -- and especially during times of crisis. And if we are wrong, we need to be agile, fail quickly and fail forward --- learn and grow and adapt --- always.

Don Berwick, former president of IHI and head of CMMS under President Obama said recently, “In healthcare we should cut measurement by 75 percent."

His point? We over-rely on data. And we forget what Deming really said.

We over-measure and get data -- not information, not wisdom, but data -- and the data clouds our decision making.

As a leader, and especially during crisis … we must come to grips with this reality and lead anyway.

Leading with agility is all of the above.

And most importantly, it is a matter of turning thoughts and ideas into right action.

Quick quiz; five frogs were sitting on a log. Three frogs decided to jump off the log. How many frogs were left on the log?

Answer: Five.

Yes, five frogs were still sitting on the log because deciding to do something and actually doing so are two different things.

It is also essential to be humble in the process. If you are honest with yourself and your circumstances, you know you will fail at various points along your journey. But you must get back up -- always. And you do it having learned from your failures. 

You have to endure the process while maintaining your True North. Your mission and your organization’s mission and values and all the behaviors derived from these must not go away during times of crisis. They must not be pushed to the wayside as we are being agile.

Our mission and values must be more than words on a wall or in an annual report. They must guide us always and especially now.

I remember speaking with a hospital CEO a number of years back. Times were tough. Financials were challenging. And then he said something I will never forget: “I don’t have time for quality; I am focused on increasing market share.”

Hearing someone else lose sight of their organization’s mission, vision and values during times of crisis helps make it clear for the rest of us what the problem is likely to become if we also panic.

Be agile – yes. And never forget that means being true to your sense of doing the right thing for the right reasons.

Two other factors

 A leader must inspire -- and to do so, a leader must instill Hope and have Faith.

Many terrific leaders I know often say, "Hope is not a strategy." And for many in the business world -- a world often led by data, action and logic -- many believe this makes a lot of sense. It is logical. One cannot sit back, do nothing, and simply hope things will improve.

That said, my philosophy had always been, “Hope may not be a strategy ... it is even more important. Hope is the foundation for All.”

Hope is what gets many people up in the morning -- especially in healthcare and especially during these times of crisis.

We are moved to act by the Hope that we will make a difference.

We act decisively with the firm Hope that we will make things better.

We push ourselves to our limits animated by the Hope that we will save a life … a soul … a community.

Without Hope -- and especially during times of crisis -- it doesn’t matter if we have the soundest strategy. Without Hope people won’t be present, people won’t be inspired, people will not take the right action when times are tough, and we will not achieve betterment for others.

That said, my thinking has evolved a bit more as of late.

When we bring Hope and Faith together -- and if we add Courage (which comes from the root word couer, which means heart) -- we move into right action. And here is why.

At the heart of Faith is certainty. It is a deep-seated truth we feel in our hearts and our souls. It’s intrinsic belief. Even if something seems to make no sense logically or based on the data, with Faith and Hope we might well proceed to transcend the hopeless. (Again, think of Deming and the limitations of data and measurement).

Hopelessness leads to the inaction of despair and doubt. When we think things are truly hopeless, we don’t act – because no action makes any sense. Hope and Faith can lead to acts of inner strength against the hopelessness of sitting idle. And they lead to expansion against the contraction of fear.

Sometimes Faith and Hope are all we have, and as leaders we must leverage each to inspire our teams who are scared, who are hurting, who truly need us.

A friend recently sent me a note in which he included an angel of faith.  And in it, Faith was described as, "the unshakable knowing of the heart when nothing makes sense to the mind."

I think Deming would approve.

Share Hope. Have Faith. Then Lead, Serve … and Love.


ABOUT THE AUTHOR: Thomas Dahlborg began his career within the walls of a community hospital as a transport aid, IV aid, and housekeeper. Here he witnessed the impact of relationship and connection within a healthcare system on clinicians and staff, and patients and families, and communities.

Now with over 35 years as a healthcare leader, including six years as the Executive Director for the Hygeia Foundation (a relationship centered care research institute), four years as the leader of the Parent Partner Program for the National Institute for Children’s Health Quality (NICHQ), currently as the Executive Director of the Michigan Center for Clinical Systems Improvement (Mi-CCSI), and also as a patient who himself was informed he would never work again and to get in line for a heart transplant, he continues to drive improved engagement, experience, clinical outcomes and safety for all through a balance of heart and mind.

Tom brings his strong knowledge base coupled with the ability to articulate his passion to position others to achieve their desired results and together make healthcare better -- for employees to work, physicians to practice medicine, patients and families to receive care, and communities to thrive.

He is also the author of the book The Big Kid and Basketball … and the lessons he taught his Father & Coach. Through his writing and speaking he is creating awareness of adverse childhood experiences (ACES) and their impact on children and adults, and trying to put an end to bullying. Tom recently contributed to the new book out of the U.K., Bullied Back to Life, which brings his message of resilience, leadership, human connection and faith overseas.

In Fall 2020, Tom also expects to publish his healthcare book From Heart to Head and Back Again … a journey through the healthcare system and create a call to action for betterment for all.